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Rituximab Plus Lenalidomide for Patients With Relapsed / Refractory Indolent Non-Hodgkin's Lymphoma (Follicular Lymphoma and Marginal Zone Lymphoma)

A Phase 3, Double-blind, Randomized Study to Compare the Efficacy and Safety of Rituximab Plus Lenalidomide (CC-5013) Versus Rituximab Plus Placebo in Subjects With Relapsed/Refractory Indolent Lymphoma

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01938001
Acronym
AUGMENT
Enrollment
358
Registered
2013-09-10
Start date
2013-11-21
Completion date
2022-01-26
Last updated
2023-02-22

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Lymphoma, Non-Hodgkin

Keywords

Non-Hodgkins Follicular lymphoma, Non-Hodgkins Marginal zone lymphoma, treatment for follicular lymphoma, treatment for Marginal zone lymphoma

Brief summary

This double-blind randomized, parallel group study will evaluate the efficacy and safety of lenalidomide (Revlimid, CC-5013) in combination with rituximab (MabThera/Rituxan) in patients with relapsed or refractory follicular lymphoma or marginal zone lymphoma. Patients will be randomized to receive either lenalidomide or placebo for twelve 28-day cycles in combination with rituximab. Anticipated time on study treatment is 1 year.

Detailed description

Indolent lymphoma is a slow growing but incurable lymphoma which includes follicular lymphoma and marginal zone lymphoma. Follicular lymphoma and marginal zone lymphoma are cancers of the B lymphocyte, a type of white blood cell. Lenalidomide is an immunomodulatory drug (a drug that affects the immune system) which alters the body's immune system and it may also interfere with the development of tiny blood vessels involved in tumor growth. Therefore, lenalidomide may reduce or prevent the growth of cancer cells. Lenalidomide has also been shown to restore the immune cells' ability to attack and kill tumor cells, an ability that may be inhibited by follicular lymphoma and other lymphomas. The combination of rituximab and lenalidomide may eliminate the cancer while restoring the immune system's ability to attack tumor cells.

Interventions

DRUGRituximab

Rituximab 375mg/m\^2 IV every week in Cycle 1 (Days 1, 8, 15 and 22) on Day 1 of every 28 day cycle from Cycles 2 to 5

DRUGLenalidomide

Lenalidomide 20mg by mouth (PO) daily on Days 1 to 21 every 28 days up to 12 cycles

DRUGPlacebo

Placebo (identical matched capsule) PO daily on Days 1 to 21 every 28 days

Sponsors

Celgene
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Age ≥18 years at the time of signing the informed consent document. * Understand and voluntarily sign an informed consent document prior to any study related assessments/procedures are conducted. * Histologically confirmed marginal zone lymphoma or follicular lymphoma (grade 1, 2 or 3a; CD20+ by flow cytometry or histochemistry). * Previously treated with at least one prior systemic chemotherapy, immunotherapy or chemoimmunotherapy and have received at least 2 previous doses of rituximab. * Documented relapsed, refractory or progressive disease after treatment with systemic therapy and must not be rituximab-refractory. * Investigator considers rituximab monotherapy appropriate. * Bi-dimensionally measurable disease on cross sectional imaging by X-ray computed tomography (CT) or magnetic resonance imaging (MRI). * Need of treatment for relapsed, progressed or refractory disease as assessed by the investigator. * Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2. * Adequate bone marrow function. * Willingness to follow study visit schedule, pregnancy precautions and other protocol requirements.

Exclusion criteria

* Histology other than follicular or marginal zone lymphoma or clinical evidence of transformation or Grade 3b follicular lymphoma. * Subjects taking corticosteroids during the last week prior to study treatment, unless administered at a dose equivalent to \< 20 mg/day prednisone or prednisolone. * Systemic anti-lymphoma therapy within 28 days or use of antibody agents within 8 weeks use of radioimmunotherapy within 6 months. * Known seropositive for or active viral infection with hepatitis B virus (HBV) or/and human immunodeficiency virus (HIV). * Known hepatitis C virus (HCV) positive with chronic HCV or active viral infection with HCV hepatitis requiring anti-viral medication (at time of randomization). * Life expectancy \< 6 months. * Known sensitivity or allergy to murine products. * Prior history of malignancies, other than follicular or marginal zone lymphoma, unless the subject has been free of the disease for ≥ 5 years. * Prior use of lenalidomide. * Known allergy to thalidomide. * Neuropathy \> Grade 1. * Presence or history of central nervous system involvement by lymphoma. * Subjects who are at a risk for a thromboembolic event and are not willing to take prophylaxis for it. * Uncontrolled intercurrent illness. * Any significant medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent document. * Pregnant or lactating females. * Any condition that places the subject at unacceptable risk if he/she were to participate in the study or that confounds the ability to interpret data from the study.

Design outcomes

Primary

MeasureTime frameDescription
Kaplan Meier Estimate of Progression Free Survival Assessed by the Independent Review Committee (IRC) According to the 2007 International Working Group Response Criteria (IWGRC)From randomization of study drug up to disease progression or death, which occurred first; up to the data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).Progression-free survival (PFS) was defined as the time from date of randomization into the study to the first observation of documented disease progression or death due to any cause, whichever occurred first. PFS was based on the data from the IRC review using the modified 2007 International Working Group Response Criteria (IWGRC) using FDA censoring rules.

Secondary

MeasureTime frameDescription
Kaplan-Meier Estimate of Overall Survival (OS)From date of randomization to death due to any cause (Average of 55.71 months and a maximum up to 95.2 months)Overall survival was defined as the time from randomization to death from any cause. Overall survival was censored at the last date that the participant was known to be alive for participants who were alive at the time of analysis and for participants who were lost to follow-up before death was documented.
Percentage of Participants With an Objective Response as Assessed by the IRC According to the 2007 IWGRCFrom date of first dose to data cut-off date of 22 June 2018; the median treatment duration was 11.19 months in the rituximab/lenalidomide arm and 11.04 months in the rituximab/placebo armPercentage of participants with an objective response is defined as having a response of at least a PR during the study without administration of new anti-lymphoma therapy. A complete response = a complete disappearance of all detectable clinical and radiographic evidence of disease, disappearance of any disease-related symptoms, and normalization of biochemical abnormalities; a partial response (PR) = 50% decrease in SPD of the 6 largest dominant nodes or nodal masses. No increase in the size of other nodes, liver, or spleen. Splenic and hepatic nodules must regress by at least 50% in the SPD.
Percentage of Participants With a Best Response of Complete Response as Assessed by the IRC According to the 2007 IWGRCFrom date of first dose up to data cut-off date of 22 June 2018; the median treatment duration was 11.19 months in the rituximab/lenalidomide arm and 11.04 months in the rituximab/placebo armPercentage of participants with a best response of at CR during the study without administration of new anti-lymphoma therapy. A CR = Complete disappearance of all detectable clinical and radiographic evidence of disease, disappearance of any disease-related symptoms, and normalization of biochemical abnormalities.
Kaplan-Meier Estimate of Duration of Objective Response as Assessed by the IRC According to the 2007 IWGRCFrom randomization up to data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).Duration of response (DOR) was defined as the time from initial response (at least PR) until documented progressive disease (PD) or death. Participants who had not progressed at the time of analysis were censored at the last assessment date that the participant was known to be progression free. Participants who received a new treatment without documented progression were censored at the last assessment date that the participants was known to be progression free.
Durable Complete Response Rate (DCCR) as Assessed by the IRC According to the 2007 IWGRCFrom first dose of investigational product (IP) to data cut-off date of 22 June 2018; the median treatment duration was 11.19 months in the rituximab/lenalidomiade arm and 11.04 months in the rituximab/placebo armDCCR was defined as the percentage of participants with a best response of complete response (CR) that lasted no less than one year (≥ 48 weeks) during the study prior to administration of new anti-lymphoma therapy. A CR is defined as a complete disappearance of any disease-related symptoms and normalization of biochemical abnormalities.
Kaplan Meier Estimate of Event Free Survival as Assessed by the IRC According to the 2007 IWGRCFrom date of randomization to data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).Event-free survival (EFS) was defined as the time from date of randomization to date of first documented progression, relapse, institution of new anti-lymphoma treatment (chemotherapy, radiotherapy or immunotherapy) or death from any cause. Responding participants and those who were lost to follow up were censored at their last tumor assessment date.
Kaplan Meier Estimate of Time to Next Anti-Lymphoma Treatment (TTNLT)From date of randomization to date of first documented administration of a new anti-lymphoma treatment (Average of 55.71 months and a maximum up to 95.2 months)Time to next anti-lymphoma treatment (TTNLT) was defined as the time from date of randomization to date of first documented administration of a new anti-lymphoma treatment (including chemotherapy, radiotherapy, radioimmunotherapy or immunotherapy). The time to the next anti-lymphoma treatment was of special interest to the study.
Number of Participants With Treatment Emergent Adverse Events (TEAEs)From first dose to 28 days post last dose (Average of 55.71 months and a maximum up to 95.2 months)TEAEs include AEs that started or worsened between the date of the first dose and 28 days after the date of the last dose. A serious adverse event (SAE) is any: • Death; • Life-threatening event; • Any inpatient hospitalization or prolongation of existing hospitalization; • Persistent or significant disability or incapacity; • Congenital anomaly or birth defect; • Any other important medical event. The investigator determined the relationship of an AE to study drug based on the timing of the AE relative to drug administration and whether or not other drugs, therapeutic interventions, or underlying conditions could provide a sufficient explanation for the event. The severity of an AE was evaluated by the investigator according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) (Version 4.03) where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening and Grade 5 = Death
Kaplan-Meier Estimate of Duration of Complete Response (DOCR) as Assessed by the IRC According to the 2007 IWGRCFrom randomization up to data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).DOCR was defined as the time from initial CR until documented PD or death. Participants who had not progressed at the time of analysis were censored at the last assessment date that the participant was known to be progression free. Participants who received a new treatment without documented progression were censored at the last assessment date that the participants was known to be progression free.

Countries

Belgium, Brazil, China, Czechia, France, Germany, Israel, Italy, Japan, Poland, Portugal, Puerto Rico, Russia, Spain, Turkey (Türkiye), United Kingdom, United States

Participant flow

Participants by arm

ArmCount
Rituximab + Lenalidomide (R^2)
Participants received rituximab 375 mg/m\^2 intravenously (IV) every week in Cycle 1 (Days 1, 8, 15 and 22) and on Day 1 of every 28-day cycle from Cycles 2 to 5 plus lenalidomide 20 mg by mouth (PO) once daily on Days 1 to 21 every 28 days up to 12 cycles (21-day treatment and 7-day rest period); if creatinine clearance (CrCl) was ≥ 30 mL/min but \< 60 mL/min, participants received lenalidomide 10 mg capsules on days 1 to 21 every 28 days.
178
Rituximab + Placebo
Participants received rituximab 375 mg/m\^2 IV every week in Cycle 1 (Days 1, 8, 15 and 22) and on Day 1 of every 28-day cycle from cycle 2 to 5 plus placebo (identically matched capsule) once daily on Days 1 to 21 of every 28-day cycle up to 12 cycles.
180
Total358

Withdrawals & dropouts

PeriodReasonFG000FG001
Pre-TreatmentAdverse Event unrelated to Study Drug10
Pre-TreatmentDeath10
TreatmentAdverse Event148
TreatmentDeath20
TreatmentOther reasons21
TreatmentProgressive Disease2154
TreatmentWithdrawal by Subject137

Baseline characteristics

CharacteristicRituximab + PlaceboTotalRituximab + Lenalidomide (R^2)
Age, Continuous61.48 Years
STANDARD_DEVIATION 11.16
61.89 Years
STANDARD_DEVIATION 11.186
62.30 Years
STANDARD_DEVIATION 11.227
Ethnicity (NIH/OMB)
Hispanic or Latino
20 Participants44 Participants24 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
158 Participants305 Participants147 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
2 Participants9 Participants7 Participants
Race/Ethnicity, Customized
Not Collected or Reported
1 Participants7 Participants6 Participants
Race/Ethnicity, Customized
Other Races
64 Participants118 Participants54 Participants
Race/Ethnicity, Customized
White
115 Participants233 Participants118 Participants
Sex: Female, Male
Female
83 Participants186 Participants103 Participants
Sex: Female, Male
Male
97 Participants172 Participants75 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
27 / 17847 / 180
other
Total, other adverse events
170 / 176158 / 180
serious
Total, serious adverse events
45 / 17625 / 180

Outcome results

Primary

Kaplan Meier Estimate of Progression Free Survival Assessed by the Independent Review Committee (IRC) According to the 2007 International Working Group Response Criteria (IWGRC)

Progression-free survival (PFS) was defined as the time from date of randomization into the study to the first observation of documented disease progression or death due to any cause, whichever occurred first. PFS was based on the data from the IRC review using the modified 2007 International Working Group Response Criteria (IWGRC) using FDA censoring rules.

Time frame: From randomization of study drug up to disease progression or death, which occurred first; up to the data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).

Population: The ITT population was defined as all participants who were randomized into the trial, regardless of whether they received study treatment or not.

ArmMeasureValue (MEDIAN)
Rituximab + Lenalidomide (R^2)Kaplan Meier Estimate of Progression Free Survival Assessed by the Independent Review Committee (IRC) According to the 2007 International Working Group Response Criteria (IWGRC)39.4 months
Rituximab + PlaceboKaplan Meier Estimate of Progression Free Survival Assessed by the Independent Review Committee (IRC) According to the 2007 International Working Group Response Criteria (IWGRC)14.1 months
p-value: <0.000195% CI: [0.34, 0.62]Log Rank
Secondary

Durable Complete Response Rate (DCCR) as Assessed by the IRC According to the 2007 IWGRC

DCCR was defined as the percentage of participants with a best response of complete response (CR) that lasted no less than one year (≥ 48 weeks) during the study prior to administration of new anti-lymphoma therapy. A CR is defined as a complete disappearance of any disease-related symptoms and normalization of biochemical abnormalities.

Time frame: From first dose of investigational product (IP) to data cut-off date of 22 June 2018; the median treatment duration was 11.19 months in the rituximab/lenalidomiade arm and 11.04 months in the rituximab/placebo arm

Population: The ITT population was defined as all participants who were randomized into the trial, regardless of whether they received study treatment or not.

ArmMeasureValue (NUMBER)
Rituximab + Lenalidomide (R^2)Durable Complete Response Rate (DCCR) as Assessed by the IRC According to the 2007 IWGRC25.3 Percentage of Participants
Rituximab + PlaceboDurable Complete Response Rate (DCCR) as Assessed by the IRC According to the 2007 IWGRC11.1 Percentage of Participants
p-value: 0.0006Cochran-Mantel-Haenszel
Secondary

Kaplan-Meier Estimate of Duration of Complete Response (DOCR) as Assessed by the IRC According to the 2007 IWGRC

DOCR was defined as the time from initial CR until documented PD or death. Participants who had not progressed at the time of analysis were censored at the last assessment date that the participant was known to be progression free. Participants who received a new treatment without documented progression were censored at the last assessment date that the participants was known to be progression free.

Time frame: From randomization up to data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).

Population: Participants who achieved a complete response in the ITT population.

ArmMeasureValue (MEDIAN)
Rituximab + Lenalidomide (R^2)Kaplan-Meier Estimate of Duration of Complete Response (DOCR) as Assessed by the IRC According to the 2007 IWGRCNA months
Rituximab + PlaceboKaplan-Meier Estimate of Duration of Complete Response (DOCR) as Assessed by the IRC According to the 2007 IWGRCNA months
p-value: 0.299395% CI: [0.32, 1.43]Log Rank
Secondary

Kaplan-Meier Estimate of Duration of Objective Response as Assessed by the IRC According to the 2007 IWGRC

Duration of response (DOR) was defined as the time from initial response (at least PR) until documented progressive disease (PD) or death. Participants who had not progressed at the time of analysis were censored at the last assessment date that the participant was known to be progression free. Participants who received a new treatment without documented progression were censored at the last assessment date that the participants was known to be progression free.

Time frame: From randomization up to data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).

Population: Participants who achieved an objective response in the ITT population.

ArmMeasureValue (MEDIAN)
Rituximab + Lenalidomide (R^2)Kaplan-Meier Estimate of Duration of Objective Response as Assessed by the IRC According to the 2007 IWGRC36.6 months
Rituximab + PlaceboKaplan-Meier Estimate of Duration of Objective Response as Assessed by the IRC According to the 2007 IWGRC21.7 months
p-value: 0.001595% CI: [0.36, 0.79]Log Rank
Secondary

Kaplan Meier Estimate of Event Free Survival as Assessed by the IRC According to the 2007 IWGRC

Event-free survival (EFS) was defined as the time from date of randomization to date of first documented progression, relapse, institution of new anti-lymphoma treatment (chemotherapy, radiotherapy or immunotherapy) or death from any cause. Responding participants and those who were lost to follow up were censored at their last tumor assessment date.

Time frame: From date of randomization to data cut-off date of 22 June 2018; overall median follow-up time for all participants was 28.30 months (range: 0.1 to 51.3 months).

Population: The ITT population was defined as all participants who were randomized into the trial, regardless of whether they received study treatment or not.

ArmMeasureValue (MEDIAN)
Rituximab + Lenalidomide (R^2)Kaplan Meier Estimate of Event Free Survival as Assessed by the IRC According to the 2007 IWGRC27.6 months
Rituximab + PlaceboKaplan Meier Estimate of Event Free Survival as Assessed by the IRC According to the 2007 IWGRC13.9 months
p-value: <0.000195% CI: [0.38, 0.67]Stratified Log-Rank Test
Secondary

Kaplan-Meier Estimate of Overall Survival (OS)

Overall survival was defined as the time from randomization to death from any cause. Overall survival was censored at the last date that the participant was known to be alive for participants who were alive at the time of analysis and for participants who were lost to follow-up before death was documented.

Time frame: From date of randomization to death due to any cause (Average of 55.71 months and a maximum up to 95.2 months)

Population: The ITT population is defined as all participants who were randomized into the trial, regardless of whether they received study treatment or not.

ArmMeasureValue (MEDIAN)
Rituximab + Lenalidomide (R^2)Kaplan-Meier Estimate of Overall Survival (OS)NA Months
Rituximab + PlaceboKaplan-Meier Estimate of Overall Survival (OS)NA Months
Comparison: Stratified by 3 factors: previous rituximab treatment, time since last antilymphoma therapy (≤ 2, \> 2 years), and disease histology (FL, MZL).95% CI: [0.37, 0.95]
Secondary

Kaplan Meier Estimate of Time to Next Anti-Lymphoma Treatment (TTNLT)

Time to next anti-lymphoma treatment (TTNLT) was defined as the time from date of randomization to date of first documented administration of a new anti-lymphoma treatment (including chemotherapy, radiotherapy, radioimmunotherapy or immunotherapy). The time to the next anti-lymphoma treatment was of special interest to the study.

Time frame: From date of randomization to date of first documented administration of a new anti-lymphoma treatment (Average of 55.71 months and a maximum up to 95.2 months)

Population: The ITT population was defined as all participants who were randomized into the trial, regardless of whether they received study treatment or not.

ArmMeasureValue (MEDIAN)
Rituximab + Lenalidomide (R^2)Kaplan Meier Estimate of Time to Next Anti-Lymphoma Treatment (TTNLT)73.1 Months
Rituximab + PlaceboKaplan Meier Estimate of Time to Next Anti-Lymphoma Treatment (TTNLT)31.8 Months
p-value: <0.000195% CI: [0.39, 0.71]Stratified Log Rank Test
Secondary

Number of Participants With Treatment Emergent Adverse Events (TEAEs)

TEAEs include AEs that started or worsened between the date of the first dose and 28 days after the date of the last dose. A serious adverse event (SAE) is any: • Death; • Life-threatening event; • Any inpatient hospitalization or prolongation of existing hospitalization; • Persistent or significant disability or incapacity; • Congenital anomaly or birth defect; • Any other important medical event. The investigator determined the relationship of an AE to study drug based on the timing of the AE relative to drug administration and whether or not other drugs, therapeutic interventions, or underlying conditions could provide a sufficient explanation for the event. The severity of an AE was evaluated by the investigator according to National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) (Version 4.03) where Grade 1 = Mild, Grade 2 = Moderate, Grade 3 = Severe, Grade 4 = Life-threatening and Grade 5 = Death

Time frame: From first dose to 28 days post last dose (Average of 55.71 months and a maximum up to 95.2 months)

Population: The safety population was defined as all participants who have received at least one dose of study medication.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any CTCAE GR 3/4 TEAE Related to LEN/PBO101 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE174 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any CTCAE GR 3/4 TEAE Related to RIT57 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any Serious TEAE Related to LEN/PBO23 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any GR 5 TEAE2 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Related to Rituximab (RIT)134 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Dose Reduction LEN/PBO46 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any Serious TEAE Related to RIT13 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Dose Interruption LEN/PBO113 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Related to Lenalidomide/Placebo (LEN/PBO)159 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Dose Interruption RIT59 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Discontinuation of LEN/PBO15 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any CTCAE Grade (GR) 3/4 TEAE121 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Discontinuation of RIT6 Participants
Rituximab + Lenalidomide (R^2)Number of Participants With Treatment Emergent Adverse Events (TEAEs)Any Serious TEAE45 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Discontinuation of RIT2 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE173 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Related to Lenalidomide/Placebo (LEN/PBO)118 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Related to Rituximab (RIT)105 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any Serious TEAE25 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any Serious TEAE Related to LEN/PBO8 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any Serious TEAE Related to RIT4 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any CTCAE Grade (GR) 3/4 TEAE58 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any CTCAE GR 3/4 TEAE Related to LEN/PBO38 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any CTCAE GR 3/4 TEAE Related to RIT20 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any GR 5 TEAE2 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Dose Reduction LEN/PBO6 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Dose Interruption LEN/PBO47 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Discontinuation of LEN/PBO9 Participants
Rituximab + PlaceboNumber of Participants With Treatment Emergent Adverse Events (TEAEs)Any TEAE Leading to Dose Interruption RIT38 Participants
Secondary

Percentage of Participants With a Best Response of Complete Response as Assessed by the IRC According to the 2007 IWGRC

Percentage of participants with a best response of at CR during the study without administration of new anti-lymphoma therapy. A CR = Complete disappearance of all detectable clinical and radiographic evidence of disease, disappearance of any disease-related symptoms, and normalization of biochemical abnormalities.

Time frame: From date of first dose up to data cut-off date of 22 June 2018; the median treatment duration was 11.19 months in the rituximab/lenalidomide arm and 11.04 months in the rituximab/placebo arm

Population: The ITT population was defined as all participants who were randomized into the trial, regardless of whether they received study treatment or not.

ArmMeasureValue (NUMBER)
Rituximab + Lenalidomide (R^2)Percentage of Participants With a Best Response of Complete Response as Assessed by the IRC According to the 2007 IWGRC33.7 Percentage of Participants
Rituximab + PlaceboPercentage of Participants With a Best Response of Complete Response as Assessed by the IRC According to the 2007 IWGRC18.3 Percentage of Participants
p-value: =0.001Cochran-Mantel-Haenszel
Secondary

Percentage of Participants With an Objective Response as Assessed by the IRC According to the 2007 IWGRC

Percentage of participants with an objective response is defined as having a response of at least a PR during the study without administration of new anti-lymphoma therapy. A complete response = a complete disappearance of all detectable clinical and radiographic evidence of disease, disappearance of any disease-related symptoms, and normalization of biochemical abnormalities; a partial response (PR) = 50% decrease in SPD of the 6 largest dominant nodes or nodal masses. No increase in the size of other nodes, liver, or spleen. Splenic and hepatic nodules must regress by at least 50% in the SPD.

Time frame: From date of first dose to data cut-off date of 22 June 2018; the median treatment duration was 11.19 months in the rituximab/lenalidomide arm and 11.04 months in the rituximab/placebo arm

Population: The ITT population was defined as all participants who were randomized into the trial, regardless of whether they received study treatment or not.

ArmMeasureValue (NUMBER)
Rituximab + Lenalidomide (R^2)Percentage of Participants With an Objective Response as Assessed by the IRC According to the 2007 IWGRC77.5 Percentage of Participants
Rituximab + PlaceboPercentage of Participants With an Objective Response as Assessed by the IRC According to the 2007 IWGRC53.3 Percentage of Participants
p-value: <0.0001Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Apr 17, 2026